纳络酮对缺氧缺血性脑病新生儿血浆神经肽Y和β-内啡肽的影响

Effects of naloxone on plasma neuropeptide Y and beta-endorphin in neonates with hypoxic - ischemic encephalopathy

目的探讨新生儿缺氧缺血性脑病(HIE)血浆神经肽Y(NPY)、β-内啡肽(β-EP)的变化及纳络酮治疗后对其的影响。方法将34例中、重度HIE患儿随机分成常规治疗组(18例),纳络酮治疗组(16例),以14例正常新生儿为对照组,纳络酮治疗组入院后在常规治疗的基础上给予纳络酮治疗,连用3天。HIE患儿组治疗前、治疗3d后各采血收集标本一次,采用放射免疫法测定NPY、β-EP。结果①HIE患儿血浆NPY、β-EP水平为(174.23±18.31)ng／L、(123.36±16.42)ng／L均显著高于正常对照组(87.19±12.95)ng／L、(63.27±12.65)ng／L(P<0.01)。HIE急性期NPY与β-EP呈正相关(r=0.347,P<0.05)。②HIE常规组、纳络酮组治疗3d后血浆NPY、β-EP水平均较治疗前显著降低(P<0.01)。治疗后HIE纳络酮组NPY、β-EP水平均显著低于常规组(P<0.01)。结论NPY、β-EP共同参与了HIE的病理生理过程,在HIE发病机制中可能起重要作用;纳络酮能显著降低NPY、β-EP水平,减轻脑损伤。

Objective To study the dynamic changes of plasma neuropeptide Y(NPY) and beta-endorphin(β-EP) level in neonates with hypoxic-ischemic encephalopathy(HIE) and the influences of naloxone on such parameters. Methods 34 neonates with moderate and severe HIE were randomly divided into two groups including routine(n=18) and naloxone tre-atments(n=16),with 14 healthy full-term neonates as normal controls. Based on the routine treatment, naloxone was given intravenously in the naloxone treatment group for 3 days. Blood samples were collected before and after treatment respectively .The levels of NPY and P-EP were measured with radioimmunoassay(RIA). Results (1 )The plasma levels of NPY、β-EP in neonates with HIE were 174.23±18.31 ng/L、123.36± 16.42 ng/L, significantly higher than those in normal control group(87.19± 12.95 ng/L、63.27±12.65 ng/L,P<0.01). Correlation analysis showed that in neonates with HIE、NPY levels correlated positively with β-EP (r=0.347,P<0.05).(2)The plasma levels of NPY and β-EP after treatment were significantly lower than those before treatment in routine and naloxone treatment groups(P<0.01). While the levels of NPY and β-EP in naloxone treatment group were significantly lower than those in routine treatment group (P<0.01). Conclusions NPY and β-EP levels are closely associated with the pathophysiological process of HIE,and may play important roles in the pathogenesis of HIE. Naloxone can significantly reduce the levels of NPY 、β-EP and alleviate brain injury.